Page 619 - Clinical Hematology_ Theory _ Procedures ( PDFDrive )

CHAPTER 29 ■ Body Fluid Analysis 603

Peritoneal cavity

Peritoneum

Superior surface (roof) Urinary bladder
of bladder
Ureteric orifice
Supravesical fossa
Rectovesical pouch
Median umbilical ligament
Transverse rectal fold
Apex of bladder Internal urethral orifice

Linea alba Ampulla of rectum

Rectovesical septum
Pubic symphysis

Retropubic space/fat pad Prostate

Intramural part of urethra Prostatic utricle

Fundiform ligament of penis Prostatic and
intermediate urethra
Puboprostatic ligament
Perineal membrane
Suspensory ligament of penis

External urethral sphincter External anal sphincter

Spongy urethra Anal canal

Internal anal sphincter

Glans penis

Navicular fossa
Prepuce Head of epididymis

External urethral opening
Testis

FIGURE 29.8 Sagittal section o the male pelvis. T e peritoneum drapes over the relatively simple topology o the

bladder and rectum. T e prostate gland, which is subject to hyperplasia with advancing age, can be palpated via
the rectum. (Reprinted rom Moore KL, Dalley AF. Clinically Oriented Anatomy, 5th ed, Baltimore, MD: Lippincott

Williams & Wilkins, 2006, Fig. 3.17A, p. 397, with permission.)

It is recommended that a 3- to 5-day period o sexual it is collected at home. In addition, they must be aware that it

abstinence be observed be ore specimen collection. wo days must be delivered promptly to the laboratory.

may be su cient; the period should not exceed 5 days. Condoms

treated with spermicide or lubricants with spermicidal Macroscopic Exam ination

properties must be avoided during specimen collection. In addi- A resh specimen should be examined or coagulum orma-

tion, patients need to be advised to keep the specimen warm, i tion (lique action), color, pH, volume, and viscosity. Tis pro-

cedure, in CLSI ormat, is provided on this book’s companion

Web site at thepoint.lww.com/ urgeon6e. T e results may be

TABLE 29.12 Composition of Seminal Fluid use ul not only in the assessment o ertility but also in the
detection o other disorders.

Structure Component

Testicle Sperm, steroids: testosterone

and dihydrotestosterone TABLE 29.13 Threshold Values of Semen

Testicle or epididymis Androgen-binding protein

Testicle (most probable Proteins (enzymes), lipids, Classi cation * Values

source) electrolytes
Subfertile <13.5 × 10 /mL sperm concentration
6
Epididymis Carnitine, acetyl carnitine, <32% of sperm with motility

glyceryl phosphorylcholine
<9% of sperm with normal
Seminal vesicles Flavin, fructose, prostaglandins morphologic features

Seminal vesicles and Magnesium Fertile >48.0 × 10 /mL sperm concentration
6
prostate
>63% of sperm with motility
Prostate Citric acid, enzymes, zinc, p30

glycoprotein >12% of sperm with normal morpho-
logic features
Cowper’s glands, Unknown

glands of Litter * Values between subfertile and fertile are classi ed as indeterminate.